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At a recent Beck Institute Workshop, Dr. Aaron Beck discusses the future status of CBT. Dr. Beck proposes that there will be one overarching theory based on the cognitive model with information from other disciplines, and empirically supported treatment methods for each disorder. Using the example of Chronic Fatigue Syndrome, he provides his vision of a triage model that would be used to determine level of care to treat patients with various disorders.

The New York Times published a review of an article in the Lancet that showed Cognitive Behavior Therapy (CBT), combined with specialist medical care, produced clinically and statistically significant improvement as compared to stand-alone specialist medical care for chronic fatigue syndrome. The CBT group was associated with less fatigue and better physical function. Many patient advocacy groups feel the findings imply that the disorder is not due to a virus. On the contrary, the study indicates that chronic fatigue syndrome is a medical condition and CBT can help reduce many disabling symptoms.

The study included twenty-two CFS patients and twenty-two control subjects, all of whom underwent a two-step program of CBT. The initial focus of treatment is a “rehabilitative approach of a graded increase in physical activity,” while the second part emphasizes a “psychological approach that addresses thoughts and beliefs about CFS which may impair recovery.”

Upon completion of the CBT treatment, the CFS patients experienced significant improvement in their physical status as well as their cognitive performance. Furthermore, the CFS patients, who had initially shown significantly lower grey matter volume than the control subjects, showed a significant increase in grey matter volume through the work of CBT.

The results of this study, which included the partially reversed cerebral atrophy after effective CBT, are an “example of macroscopic cortical plasticity in the adult human brain, demonstrating a surprisingly dynamic relation between behavioural state and cerebral anatomy. Furthermore, (their) results reveal a possible neurobiological substrate of psychotherapeutic treatment.”

A new study in Pediatrics reported that adolescents with Chronic Fatigue Syndrome (CFS) who received 10 sessions (over 5 months) of cognitive behavioral therapy (CBT) continued to experience positive effects at 2-year follow-up. Researchers measured fatigue, functional impairment, school attendance, and work attendance (where applicable). At follow-up, participants continued to experience the same improvement in fatigue as they had at the end of treatment. Their physical functioning, school attendance, and work attendance actually improved during the follow-up period. The authors recommended that this treatment become available to more adolescent patients with CFS.